Prior to breakfast, while still at the hotel, Dr. Lieberman met with his patient from Ethiopia whom he had operated on at the Texas Plano Health hospital in February. While in Texas, he had undergone a multiple stage procedure to correct a deep infection and a pseudo-arthrosis (loose hardware, bone not healing). The patient reported that he was doing exceptionally well and was gratified to be able to have his follow up appointment in the lobby of the Lakeview resort in Mbarara rather than travel all the way back to Texas!
It is an interesting start to our day at the hospital with our first power outage at 10 am. Hopefully no machines are ruined this time, fingers crossed (incidentally, the C-arm fluoroscopy machine is still not working and is unlikely to be repaired over the span of this mission). I remember Dr. Fisk recounting how one of the local residents, Marvin, had exclaimed after our short power outage yesterday- ‘this is Africa’, then proceeded to describe how he had once performed surgery for hours without electricity. Hopefully we get our power back soon; luckily we have some generators for the theaters.
Two hours later, the electricity comes back on…
Today Dr. Lieberman operated on 11-year-old James. I’d seen James every day of the week, the first time in our spine clinic and around the hospital each day after that. Every time I saw him, I waved at him and said hi. At first he had responded very shyly and quietly, ‘I’m fine,’ but over the days, his responses would become more and more enthusiastic. As I stood in the operating theater watching Dr. Lieberman and Owusu manipulate and straighten his spine- a breathtaking process that made me think, how do people even begin to think of doing that- I couldn’t help but picture James’ face and his timid smile, I could vividly recall him walking around the hospital, or kicking around the soccer ball that we had handed him some days before. I couldn’t help but think to myself, I really hope I get to see him stand a little taller, I hope I get to see him smile a little bigger! His lengthy operation concluded a success and he is wheeled to the ICU as I hope for his speedy recovery.
Dr. Kerner starts her cases later than the other teams as she is constantly interrupted and delayed by emergency c-section after emergency c-section, but she eventually gets her operating theatre and gets started.
Dr. Lieberman doesn’t start his second patient, three-year-old Ivan, till after 6. Ivan was scheduled for surgery much earlier but disappeared only to be found hour’s later; there had been some miscommunication and his mother had mistakenly been sent to pick up Ivan’s blood, and she had taken him with her. Ivan made it back to the OR just in the nick of time before the 6 pm deadline.
Around the same time, Dr. Kerner also starts her last patient, a young girl with massive keloids on her neck…
I’m back in Dr. Lieberman’s O.R just after seven and the lights flicker and turn off again but nobody in the operating room is phased. It’s our fourth power outage of the day. Dr. Lieberman asks me to scrub into Ivan’s surgery and I hurry to the hand-washing station, excited! It’s my first time scrubbing into a spine case and I am thrilled! I assist him, Drs. Owusu and Gorlick, and we try to manipulate little Ivan’s spine slowly and carefully. I watch as his spine becomes straighter with each screw tightening; we only use as much torque to get correction yet not cut out through his delicate tuberculosis-damaged spine. Four hours later, we close him up and rush him to the ICU for recovery.
We leave the hospital exhausted at 11:15 pm- a record 15 hours- only after Dr. Lieberman takes care of the patients he finds patiently waiting to see him in the hallway.
Our final surgery tally of the day:
Spine team: 2
Ortho team: 5
Plastics team: 2
Drs Lieberman and Owusu with an Ethiopian patient for follow up in Uganda after surgery at Texas Health Plano Hospital in Feb 2014
Jik! It cleans, it sterilizes, it is SPF-50, it even goes well with vodka
Dr. Kerner screwing with Dr. Lieberman
Compassion and concern above and beyond
When the lights go out, the work continues, courtesy of the smartphone
Pillow pets supplied by Sami Petersen and ‘Shift Scoliosis’